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Pregnancy

Gestational Diabetes and kick test

10/19/1998

Question:

I am 27 weeks pregnant and have two questions.

1) I had a diabetes test at my OB/GYN the other day. I drank the sweet drink and then had a finger stick almost an hour earlier. I tested 141. My doctor said that is one point above thier cut off so I was sent for a three hour glucose tolerance test. Is 141 high? My doctor said eh didn't think I had diabetes but wanted to be safe. What is I have the diabetes? What can it do to the fetus? Does the condition reverse after pregnancy? Would glocose have been tested in my prenatal blood work?

2) My doctor also gave me instructions for a kick test. said to lie on my left side for an hour after eating ro drinking. If you don't count ten kicks you should repeat the procedure and if there are not ten kicks then call doc ASAP. I have tried this and only get one or two kicks. If I am sittung or lying on my back though I often feel lots of kicks - not sure it is ten an hour though. Is it too early for teh baby to kick so much? Should I be worried? I am trying not to be a worry wart - this is my first pregnancy.

Answer:

I do think that a screening Glucose Tolerance Test (GCT) of 141 is elevated enough to warrant a more definitive test. I am concerned that it was done as a finger stick, since the cutoff values have been established based on whole blood from a blood draw. Gestational diabetes in pregnancy can lead to large babies, difficult deliveries, and increased cesarean deliveries. Uncontrolled, it can increase the incidence of fetal malformations and fetal distress. If it is only related to pregnancy, it resolves after delivery. The incidence of non-gestational diabetes after pregnancy is 50% in the 20 years following delivery.

Kick tests (fetal movement counts) are used to monitor fetal wellbeing. You should monitor fetal movements (not just kicks) over a period of time (30-60 minutes). There is no right or wrong number of movements. You are trying to establish a baseline of fetal movements for your baby. A significant decline in fetal movements is an indicator that more specific tests of fetal wellbeing need to be performed. Most women who need more specific tests have normal testing. Fetal movement tests are best if performed after about 28 weeks.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated